Intended for healthcare professionals

Rapid response to:

Research

New point of care Chlamydia Rapid Test—bridging the gap between diagnosis and treatment: performance evaluation study

BMJ 2007; 335 doi: https://doi.org/10.1136/bmj.39402.463854.AE (Published 06 December 2007) Cite this as: BMJ 2007;335:1190

Rapid Response:

Sensitivity vs negative predictive value

It's odd that this paper is being spun as positive. I'm not sure how
reassured a
woman would be to know that there is a 17% or almost 1 in 5 chance that
the
test misses the presence of chlamydia in the average population and and
almost
1 in 3 chance in a high risk population. The only advantage of this test
is its
result's availability in 30 minutes, and I suspect the people that were
willing to
wait 30 min to 2 hours for the result were not the people that were not
getting
treated in the first place (the population that would be ideally served by
this
test).

A simple approach given this evidence would be to treat empirically
in a high
risk person (i.e. obvious PID, symptomatic contact, etc.), do either a
urine or a
cervical culture/pcr specimen depending on the clinical scenario in the
average
woman, and save the rapid test for people that you will possibly not be
able to
follow up for the result (even if you give them a prescription to take if
it's
positive, so they don't have to come back in--i.e. living on the street or
no
phone number or mental health/addictions issues that might interfere,
etc.).

Competing interests:
None declared

Competing interests: No competing interests

25 February 2008
yogi sehgal
family physician
Sioux Lookout, p8t 1a8